Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | R8F74 | MO |
NPI | 1083641971 |
---|---|
Provider Name | Dr. James M Close |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63136-6163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205059223 | (05) | MO |
E61057 | (02) |